Division of Gastroenterological and General Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
Surg Today. 2010 Apr;40(4):380-4. doi: 10.1007/s00595-009-4083-9. Epub 2010 Mar 26.
The patient was a 75-year-old asymptomatic man, in whom a tumor mass in the pancreatic tail had been found 6 months earlier. Computed tomography revealed a mass 7 cm in diameter, and an enhancement with contrast medium was observed at the periphery and partially inside the mass, but not in most parts of the tumor. Endoscopic retrograde cholangiopancreatography showed a filling defect in the main pancreatic duct. A distal pancreatectomy was performed because of the possibility of a malignant tumor. The tumor consisted of a lobular invasive growth component and a component with intraductal growth into the main pancreatic duct, and histologically the tumor cells had solid acinar to partially trabecular/tubular patterns. Trypsin (an acinic cell marker) expression was widely observed, followed by the expression of chromogranin A (an endocrine cell marker) in about 30% of the tumor cells. The tumor was diagnosed as mixed acinar-endocrine carcinoma according to the WHO classification.
患者为 75 岁无症状男性，6 个月前在胰尾发现肿瘤。计算机断层扫描显示直径 7 厘米的肿块，在肿块的外周和部分内部观察到造影剂增强，但在肿瘤的大部分区域没有。内镜逆行胰胆管造影显示主胰管内充盈缺损。由于可能是恶性肿瘤，进行了远端胰腺切除术。肿瘤由小叶浸润性生长成分和向主胰管内生长的成分组成，组织学上肿瘤细胞具有实性腺泡到部分小梁/管状形态。广泛观察到胰蛋白酶（腺泡细胞标志物）的表达，随后约 30%的肿瘤细胞中观察到嗜铬粒蛋白 A（内分泌细胞标志物）的表达。根据世界卫生组织分类，该肿瘤被诊断为混合性腺泡-内分泌癌。
